Ekonomi Bölümü Koleksiyonu

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Author: search.filters.author.Wang, L

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    Citation - WoS: 1
    Pnd29 - a Retrospective Analysis of the Economic Burden Among Patients Diagnosed With Chronic Migraine Using the Veterans Health Administration Medical Data
    (Elsevier Science Inc, 2015-05-01) Mao, X; Shrestha, S; Başer, Onur; Wang, L
    OBJECTIVES: To evaluate the health care resource utilization and costsamong patients diagnosed with chronic migraine (CM) in the Veterans HealthAdministration (VHA) medical dataset. METHODS: Patients diagnosed with CMwere identified (International Classification of Diseases, 9th Revision, ClinicalModification diagnosis code 346.XX) using the VHA dataset from October 1, 2008through September 30, 2010. The initial diagnosis date was designated as the indexdate. Patients without CM with the same age, gender and region (comparison cohort)were matched using a randomly chosen index date to minimize selection bias.Patients in both cohorts were at least age 18 years and had continuous medicaland pharmacy benefits for 1 year before and after the index date. One-to-one propensity score matching (PSM) was used to compare health care costs and utilizations between the CM and the comparison cohorts, and was adjusted for baselinedemographic and clinical characteristics. Pain scores were also included to investigate wellness after CM diagnosis. RESULTS: After risk-adjustment by PSM, 123,241patients in each cohort were matched. Significantly more CM patients had inpatientadmissions (6.44% vs. 1.75%, p<0.0001) and emergency room (ER; 14.42% vs. 5.50%,p<0.0001), outpatient office (68.80% vs. 42.15%, p<0.0001), outpatient (69.30% vs.42.91%, p<0.0001) and pharmacy visits (70.84% vs. 41.43%, p<0.0001) compared tothose without CM. Accordingly, CM patients also incurred higher costs for inpatient admissions and ER, office, outpatient and pharmacy visits compared to thosewithout CM. Total costs incurred by CM patients were $4,776, almost triple that of patients without CM ($1,756). There were more CM patients with accompanying painat all levels (mild: 19.53% vs. 0.16%; moderate: 13.10% vs. 0.10%; severe: 16.20% vs.0.12%; all p<0.0001). CONCLUSIONS: CM patients in the VHA population had substantial health care resource utilization, incurred higher costs and suffered worsepain compared to those without the disease.
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    Pdb44 - Health Care Resource Utilization and Costs Among Diabetes Patients Residing in Long-Term Care Facilities
    (Elsevier Science Inc, 2015-05-01) Huang, A; Shrestha, S; Başer, Onur; Yuce, H; Wang, L
    OBJECTIVES: To evaluate health care resource utilization and costs among diabetespatients residing in long-term care facilities. METHODS: Patients diagnosed withdiabetes (International Classification of Diseases, 9th Revision, Clinical Modificationdiagnosis codes 250.x0, 250.x2) were identified using the Long-Term Care MinimumData Set (MDS) linked to 5% Medicare data from 01JAN2009 through 31DEC2010. Theinitial diagnosis date was designated as the index date. A comparison cohort wascreated for patients without diabetes, using 1:1 propensity score matching (PSM)to control for age, region, gender and baseline Charlson Comorbidity Index score.The index date for the comparison cohort was randomly chosen to reduce selection bias. Patients in both cohorts were required to be age ?65 years, have at leasttwo consecutive quarterly assessments documented in MDS data 6 months priorto the index date and have continuous medical and pharmacy benefits for 1-yearpre- and post-index date. Health care resource utilization and costs were comparedbetween the diabetes and comparison cohorts. RESULTS: After applying PSM, 783patients were included in each cohort, and baseline characteristics were balanced.Diabetes patients had a higher percentage of inpatient (31.29% vs. 22.73%, p=0.0001),skilled nursing facility (SNF, 31.55% vs. 22.73%, p<0.001), durable medical equipment (27.46% vs. 16.48%, p<0.0001) and pharmacy visit claims (93.10% vs. 88.76%,p=0.0028) compared to those without diabetes. Patients in the diabetes cohort alsoincurred significantly higher inpatient ($5,801 vs. $3,071, p<0.0001), SNF ($5,532 vs.$3,244, p<0.0001), carrier claim ($3,118 vs. $2,437, p=0.0002) and pharmacy visit costs($5,040 vs. $4,275, p=0.0005) than those in the comparison cohort. CONCLUSIONS:Patients diagnosed with diabetes had significantly higher health care resource utilization and costs than those without diabetes.
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    Demographic Distribution and Health Care Burden of Patients Diagnosed With Ankylosing Spondylitis in the Us Medicare Population
    (Elsevier Science Inc, 2015-05-01) Mao, X; Li, L; Shrestha, S; Başer, Onur; Yuce, H; Wang, L
    OBJECTIVES: To investigate the demographic distribution and health care burdenof patients diagnosed with ankylosing spondylitis (AS) using Medicare fee-forservice (FFS) data. METHODS: A retrospective analysis was performed using the100% Medicare FFS Datasets from October 1, 2008 through December 31, 2012.Patients diagnosed with AS were identified using International Classification ofDiseases, 9th Revision, Clinical Modification diagnosis code 720.0, and the firstdiagnosis date was designated as the index date. All patients were required tohave continuous medical and pharmacy benefits 1-year pre- (baseline period)and post-index date (follow-up period). Health care resource utilization and costsduring the baseline and follow-up periods were calculated. RESULTS: A total of8,990 AS patients were included in the study. The average age at diagnosis was 75years. Nearly 88.7% of patients were white, 62.97% were women and many residedin the South U.S. region (40.33%). The most common baseline comorbidities werechronic obstructive pulmonary disease (33.20%), diabetes (30.50%), cerebrovasculardisease (22.65%) and congestive heart failure (18.85%). During the follow-up period,73.04% of patients had inpatient admissions, 52.31% had emergency room visits,91.43% had outpatient office visits, 91.43% had outpatient visits and 57.67% hadpharmacy visits, resulting in average costs of, $37,077, $298, $5,397, $5,695 and$6,668, respectively. The average total costs were $49,440 during the follow-upperiod. The four most frequently prescribed medications for AS were prednisonehydrocodone (3.59%), bit/acetaminophen (3.17%), methotrexate sodium (2.79%)and levothyroxine sodium (2.42%). CONCLUSIONS: AS patient demographic andclinical characteristics in the Medicare population were assessed. Study patientswere often diagnosed with comorbid conditions, and had high health care utilization and costs.
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    Psy14 - Evaluating Trends in Chronic Pain Prevalence in the United States Veterans Health Administration Population
    (Elsevier Science Inc, 2015-05-01) Li, L.; Shrestha, S.; Başer, Onur; Yuce, H; Wang, L
    OBJECTIVES: The current study examined chronic pain prevalence in the U.S. Veterans Health Administration (VHA) population. METHODS: The study sample was based on the VHA Medical SAS Datasets from fiscal year 2008 through 2012. All patients diagnosed with chronic pain throughout the study period were identified using International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes 338.2 and 338.4. The variation in the prevalence of chronic pain was assessed and categorized according to the pain scale. Pain score was determined using a scale ranging from 0 to 10 as reported by patients using the following categories: 1 to 4: mild, 5 to 6: moderate and ?7: severe pain. To identify prior prevalence cases, we restricted continuous enrollment throughout that fiscal year and at least 2 years prior
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    Mortality and Prevalence of Major Depressive Disorder in the Us Medicare Population From 2008-2013
    (2016) Bashyal, R; Du, H; Wang, L; Yuce, H; Başer, Onur
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    Prs12 - Mortality and Rehospitalization Rates Among Hospitalized Pneumonia Patients in the Us Medicare Population
    (Elsevier Science Inc, 2015-05-01) Li, L.; Shrestha, S.; Başer, Onur; Yuce, H; Wang, L
    Objectives: To examine the mortality and rehospitalization rates among hospitalized U.S. Medicare patients diagnosed with pneumonia. Methods: Using U.S.Medicare data, 30-day and 1-year mortality rates as well as rehospitalization rateswere calculated for patients with a primary diagnosis of pneumonia (InternationalClassification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] codes480.0-483.99 or 485-487) or a secondary discharge diagnosis of pneumonia witha primary diagnosis of respiratory failure (ICD-9-CM code 518.81) or sepsis (038.xx). Patients with continuous enrollment in a fee-for-service Medicare healthplan throughout the calendar year, and at least 2 years prior, were included inthe study. Age- and gender-adjusted readmission rates were calculated by directstandardization of the U.S. population age ?65 years in 2010 using gender-specificage groups. Results: The 30-day and 1-year mortality rates increased by 5.9% (17 to18 per 1,000 person-years) and 13.2% (38 to 43 per 1,000 person-years), respectively,from 2008 to 2012. The overall adjusted readmission rates were 3.82% in 2008, 3.93%in 2009, 3.98% in 2010 and 2011, and 3.17% in 2012. Men had higher readmission ratesthan women for all study years except 2011. Patients age 65-69 years had the highestreadmission rates in 2008 (4.47%), 2009 (4.59%) and 2011 (4.77%). In 2010, patients age70-74 years (4.41%), and in 2012, patients who were age 75-79 years (3.73%) had thehighest readmission rates. Black patients had the highest readmission rates in 2008(5.08%), North American Natives in 2009 (4.86%), other race in 2010 (5.87%), Hispanicsin 2011 (5.70%) and North American Natives in 2012 (7.11%). Conclusions: AmongU.S. Medicare beneficiaries diagnosed with pneumonia, mortality rates were higherfrom 2009 to 2012 than in 2008. Overall, hospital readmission rates were lower in2012 than 2008, after adjusting for age and gender. Readmission rates varied acrossrace and age groups.
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    Pcv50 - a Retrospective Analysis of Health Care Resource Utilization and the Economic Burden Among Us Long-Term Care Facility Patients Diagnosed With Stroke
    (Elsevier Science Inc, 2015-05-01) Huang, A; Shrestha, S; Başer, Onur; Yuce, H; Wang, L
    Objectives: To assess the economic burden and health care resource utilization among patients in long-term care facilities who were diagnosed withstroke. Methods: Patients diagnosed with stroke (International Classification ofDiseases, 9th Revision, Clinical Modification diagnosis codes 433, 434 and 436) wereidentified using the Long Term Care Minimum Data Set (MDS) linked to 5% Medicaredata from 01JAN2009 through 31DEC2010. The initial diagnosis date was designatedas the index date. Patients without a stroke diagnosis (control cohort) were matchedto stroke patients, and 1:1 propensity score matching (PSM) was used to control forage, region, gender and baseline Charlson Comorbidity Index score. The index datefor the control cohort was randomly chosen to reduce selection bias. Patients inboth cohorts were required to be age ?65 years, have at least two consecutive quarterly assessments documented in MDS data 6 months prior to the index date andhave continuous medical and pharmacy benefits 1 year before and after the indexdate. Results: Once PSM was applied, 1,014 patients were included in each cohort,and baseline characteristics were balanced. A higher percentage of stroke patientshad inpatient admissions (40.34% vs. 23.37%, p<0.0001), outpatient visits (92.31%vs. 89.45%, p=0.0253), skilled nursing facility (SNF; 37.67% vs. 28.21%, p<0.0001) anddurable medical equipment (DME) claims (30.47% vs. 22.09%, p<0.0001) than thosein the control cohort. Stroke patients also incurred considerably higher inpatient($7,068 vs. $3,418, p<0.0001), outpatient ($3,545 vs. $2,539, p<0.0001), SNF ($8,036 vs.$3,695, p<0.0001), DME ($394 vs. $235, p=0.0023) and carrier claim costs ($3,606 vs.$2,489, p<0.0001) than those without a stroke diagnosis. Conclusions: Patientsdiagnosed with stroke had considerably higher health care resource utilization andcosts than those in the control cohort.